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.Principles, technical specifications, and clinical application of lung watershed topography map 2.0: A thoracic surgery expert consensus (2024 version)
Wenzhao ZHONG ; Fan YANG ; Jian HU ; Fengwei TAN ; Xuening YANG ; Qiang PU ; Wei JIANG ; Deping ZHAO ; Hecheng LI ; Xiaolong YAN ; Lijie TAN ; Junqiang FAN ; Guibin QIAO ; Qiang NIE ; Mingqiang KANG ; Weibing WU ; Hao ZHANG ; Zhigang LI ; Zihao CHEN ; Shugeng GAO ; Yilong WU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(02):141-152
With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.
3.Application of cross bar technique in repair of pectus excavatum
Tianjun ZHOU ; Dan TIAN ; Ruiqing SHI ; Zihao ZHOU ; Jiming TANG ; Dongkun ZHANG ; Xiaosong BEN ; Guibin QIAO ; Gang CHEN ; Liang XIE
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(11):1572-1578
Objective To explore the indication, surgical technique, and clinical efficacy of the cross bar based on the Nuss procedure in pectus excavatum. Methods The clinical data of patients who underwent cross bar based on the Nuss procedure from August 2023 to August 2024 in Guangdong Provincial People's Hospital were retrospectively analyzed. Results A total of 88 patients including 85 males and 3 females with a mean age of (17.56±5.20) years were enrolled. All operations were performed successfully without intraoperative cardiac injury, pericardial injury or diaphragmatic injury. The mean operation time was (147.65±47.75) min. The mean blood loss was (13.30±9.06) mL. The mean postoperative hospitalization stay was (4.81±1.55) days, without perioperative death. Six (6.82%) patients developed early postoperative complications, including 3 patients of pleural effusion, 1 patient of subcutaneous hematoma, 1 patient of suffocation and 1 patient of bar rotation. The postoperative outcomes were excellent in 71 (80.68%) patients, good in 16 (18.18%) patients and moderate in 1 (1.13%) patient. The excellent and good rate was 98.86%. Conclusion The cross bar technique is safe and convenient, with satisfactory results. It is worth promoting in clinical application.
4.Effect and Mechanism of Lobetyolin on Cholesterol Metabolism in HepG2 Cells
Ruiling YANG ; Qiang CHEN ; Guibin XIONG ; Xiaoming ZHANG ; Jie LI ; Faming WU ; Chengxin SUN
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(1):154-160
Objective To investigate the mechanism of lobetyolin's intervention in HepG2 cells abnormal cholesterol metabolism.Methods This study used oleic acid(OA)stimulation of HepG2 cells as a model.MTT assay,oil red O staining,biochemical kit assay,qRT-PCR assay,Western blot assay and NBD labeled cholesterol effection assay were used to study the effect of lobetyolin on cholesterol metabolism in HepG2 cells.Results The results showed that lobetyolin could reduce the content of lipid drops,the levels of triglyceride(TG)and total cholesterol(TC)in HepG2 cells stimulated by OA,increase cholesterol effection rate,and up-regulate cytochrome 7A1(CYP7A1),liver x receptor α(LXRα),ATP-binding cassette transporter A1(ABCA1),peroxisome proliferator-activated receptor(PPARγ)and other mRNA or protein expression levels.However,combined intervention with PPARγ antagonist Mifobate(SR-202)can significantly inhibit the promoting effect of lobetyolin on cholesterol metabolism in HepG2 cells.Conclusion This study revealed that lobetyolin can improve the cholesterol effection rate of HepG2 cells stimulated by OA and promote cholesterol catabolism,and the mechanism of action may be related to the regulation of PPARγ/CYP7A1 pathway.
5.Effect and Mechanism of Lobetyolin on Cholesterol Metabolism in HepG2 Cells
Ruiling YANG ; Qiang CHEN ; Guibin XIONG ; Xiaoming ZHANG ; Jie LI ; Faming WU ; Chengxin SUN
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(1):154-160
Objective To investigate the mechanism of lobetyolin's intervention in HepG2 cells abnormal cholesterol metabolism.Methods This study used oleic acid(OA)stimulation of HepG2 cells as a model.MTT assay,oil red O staining,biochemical kit assay,qRT-PCR assay,Western blot assay and NBD labeled cholesterol effection assay were used to study the effect of lobetyolin on cholesterol metabolism in HepG2 cells.Results The results showed that lobetyolin could reduce the content of lipid drops,the levels of triglyceride(TG)and total cholesterol(TC)in HepG2 cells stimulated by OA,increase cholesterol effection rate,and up-regulate cytochrome 7A1(CYP7A1),liver x receptor α(LXRα),ATP-binding cassette transporter A1(ABCA1),peroxisome proliferator-activated receptor(PPARγ)and other mRNA or protein expression levels.However,combined intervention with PPARγ antagonist Mifobate(SR-202)can significantly inhibit the promoting effect of lobetyolin on cholesterol metabolism in HepG2 cells.Conclusion This study revealed that lobetyolin can improve the cholesterol effection rate of HepG2 cells stimulated by OA and promote cholesterol catabolism,and the mechanism of action may be related to the regulation of PPARγ/CYP7A1 pathway.
7.Exploring lncRNA Expression Patterns in Patients With Hypertrophied Ligamentum Flavum
Junling CHEN ; Guibin ZHONG ; Manle QIU ; Wei KE ; Jingsong XUE ; Jianwei CHEN
Neurospine 2024;21(1):330-341
Objective:
Hypertrophy ligamentum flavum (LFH) is a common cause of lumbar spinal stenosis, resulting in significant disability and morbidity. Although long noncoding RNAs (lncRNAs) have been associated with various biological processes and disorders, their involvement in LFH remains not fully understood.
Methods:
Human ligamentum flavum samples were analyzed using lncRNA sequencing followed by validation through quantitative real-time polymerase chain reaction. To explore the potential biological functions of differentially expressed lncRNA-associated genes, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed. We also studied the impact of lncRNA PARD3-AS1 on the progression of LFH in vitro.
Results:
In the LFH tissues when compared to that in the nonhypertrophic ligamentum flavum (LFN) tissues, a total of 1,091 lncRNAs exhibited differential expression, with 645 upregulated and 446 downregulated. Based on GO analysis, the differentially expressed transcripts primarily participated in metabolic processes, organelles, nuclear lumen, cytoplasm, protein binding, nucleic acid binding, and transcription factor activity. Moreover, KEGG pathway analysis indicated that the differentially expressed lncRNAs were associated with the hippo signaling pathway, nucleotide excision repair, and nuclear factor-kappa B signaling pathway. The expression of PARD3-AS1, RP11-430G17.3, RP1-193H18.3, and H19 was confirmed to be consistent with the sequencing analysis. Inhibition of PARD3-AS1 resulted in the suppression of fibrosis in LFH cells, whereas the overexpression of PARD3-AS1 promoted fibrosis in LFH cells in vitro.
Conclusion
This study identified distinct expression patterns of lncRNAs that are linked to LFH, providing insights into its underlying mechanisms and potential prognostic and therapeutic interventions. Notably, PARD3-AS1 appears to play a significant role in the pathophysiology of LFH.
9.Exploring lncRNA Expression Patterns in Patients With Hypertrophied Ligamentum Flavum
Junling CHEN ; Guibin ZHONG ; Manle QIU ; Wei KE ; Jingsong XUE ; Jianwei CHEN
Neurospine 2024;21(1):330-341
Objective:
Hypertrophy ligamentum flavum (LFH) is a common cause of lumbar spinal stenosis, resulting in significant disability and morbidity. Although long noncoding RNAs (lncRNAs) have been associated with various biological processes and disorders, their involvement in LFH remains not fully understood.
Methods:
Human ligamentum flavum samples were analyzed using lncRNA sequencing followed by validation through quantitative real-time polymerase chain reaction. To explore the potential biological functions of differentially expressed lncRNA-associated genes, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed. We also studied the impact of lncRNA PARD3-AS1 on the progression of LFH in vitro.
Results:
In the LFH tissues when compared to that in the nonhypertrophic ligamentum flavum (LFN) tissues, a total of 1,091 lncRNAs exhibited differential expression, with 645 upregulated and 446 downregulated. Based on GO analysis, the differentially expressed transcripts primarily participated in metabolic processes, organelles, nuclear lumen, cytoplasm, protein binding, nucleic acid binding, and transcription factor activity. Moreover, KEGG pathway analysis indicated that the differentially expressed lncRNAs were associated with the hippo signaling pathway, nucleotide excision repair, and nuclear factor-kappa B signaling pathway. The expression of PARD3-AS1, RP11-430G17.3, RP1-193H18.3, and H19 was confirmed to be consistent with the sequencing analysis. Inhibition of PARD3-AS1 resulted in the suppression of fibrosis in LFH cells, whereas the overexpression of PARD3-AS1 promoted fibrosis in LFH cells in vitro.
Conclusion
This study identified distinct expression patterns of lncRNAs that are linked to LFH, providing insights into its underlying mechanisms and potential prognostic and therapeutic interventions. Notably, PARD3-AS1 appears to play a significant role in the pathophysiology of LFH.

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