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.Effect of Yishen Tongluo Prescription on Sperm DNA Fragmentation Index and Sperm Mitochondrial Membrane Potential in Patients with Asymptomatic Idiopathic Asthenospermia Infertility
Gaoli HAO ; Xin HE ; Lipeng FAN ; Jianshe CHEN ; Xun LI ; Hui ZHANG ; Xiang CHEN ; Shuilin LYU ; Xiaojun FU ; Zixue SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(20):145-151
ObjectiveTo explore the effect of Yishen Tongluo prescription on sperm DNA fragmentation index (DFI) and sperm mitochondrial membrane potential (MMP) in patients with asymptomatic idiopathic asthenospermia infertility. MethodsA total of 128 patients with asymptomatic idiopathic asthenospermia were randomly assigned to an experimental group (64 cases) and a control group (64 cases). The experimental group received Yishen Tongluo prescription, while the control group was treated with Wuzi Yanzongwan combined with L-carnitine oral solution. One treatment course lasted 12 weeks. Spouse pregnancy rate, sperm progressive motility (PR), total sperm motility (PR+NP), sperm function (sperm tail hypotonic swelling rate, sperm acrosin activity), sperm DFI, and sperm MMP were compared between the two groups before and after treatment. Adverse reactions were observed and recorded during the study, and clinical efficacy and safety were systematically evaluated. ResultsA total of 121 patients completed the study, including 61 in the experimental group and 60 in the control group. The spouse pregnancy rate in the experimental group was 14.75% (9/61), higher than that in the control group at 6.67% (4/60), though the difference was not statistically significant. Clinical efficacy in the experimental group was superior to that in the control group (P<0.05). Compared with the results before treatment, sperm PR, PR + NP, sperm tail hypotonic swelling rate, sperm acrosin activity, sperm DFI, and sperm MMP were significantly improved in both groups after treatment (P<0.05), with greater improvements in the experimental group (P<0.05). However, there was no significant change in sperm concentration in either group after treatment. During the study, no abnormal safety indicators or significant adverse reactions occurred in either group. ConclusionThe kidney-tonifying and collateral-dredging method shows good clinical efficacy in the treatment of asymptomatic idiopathic asthenospermia infertility. Yishen Tongluo prescription can improve sperm motility, increase spouse pregnancy rate, enhance sperm function, and demonstrates good safety. Its mechanism may be related to reducing sperm DFI and increasing sperm MMP.
3.Effect Mechanism of Guizhi Fulingwan in Regulating Sex Hormone Disorders in Rats with Benign Prostatic Hyperplasia Based on Serum Metabolomics
Chengchen LI ; Yuanpeng HUANG ; Qian ZHANG ; Dian ZENG ; Lingang KONG ; Yukun FAN ; Yuanduo XIA ; Hao CHEN ; Feng WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(24):21-29
ObjectiveTo analyse the efficacy and mechanism of Guizhi Fulingwan in regulating sex hormone disorders in rats with benign prostatic hyperplasia (BPH). MethodsThirty male SD rats were randomly divided into a sham group, a model group, a finasteride group (0.45 mg·kg-1·d-1), and low-dose and high-dose groups of Guizhi Fulingwan (0.135, 0.337 5 g∙kg-1∙d-1), with six in each group. The BPH model was prepared by subcutaneous injection of 3.5 mg∙kg-1∙d-1 testosterone propionate after debridement surgery in all groups except the sham group. The rats in the sham group and the model group were administered with an equal volume of saline by gavage, and the rest of the groups were administered with the corresponding medicinal solution by gavage for 35 days. Histopathology in rats was evaluated by prostate wet weight, volume, index, and hematoxylin-eosin (HE) staining. The serum sex hormone levels of testosterone (T), dihydrotestosterone (DHT), and estradiol (E2) were determined by enzyme-linked immunosorbent assay. The protein expression of the androgen receptor (AR) was detected by immunohistochemistry. The serum metabolism profiles of rats in the sham group, the model group, and the high-dose group of Guizhi Fulingwan were compared by ultra-high performance liquid chromatography tandem Fourier transform mass spectrometry (UHPLCQ Exactive) to screen for metabolic markers and to obtain relevant metabolic pathways. ResultsCompared with those in the sham group, the wet weight, volume, index, serum sex hormone level, and AR protein expression of the prostate in the model group were all elevated (P<0.05, P<0.01), and the histomorphology showed pathological changes. Compared with those in the model group, the wet weight, volume, index, serum sex hormone level, and AR protein expression of the prostate in the intervention groups showed a decreasing trend (P<0.05, P<0.01), and histopathology was improved. Serum metabolomics analysis obtained a total of 40 metabolic markers related to the intervention effect of Guizhi Fulingwan, such as dehydrosafynol, hyoscyamine, and lumichrome, which were involved in the pathways of autophagy, riboflavin metabolism, and retrograde endocannabinoid signaling. ConclusionGuizhi Fulingwan can effectively regulate sex hormone disorders in BPH rats, and its mechanism may be related to autophagy, riboflavin metabolism, and retrograde endocannabinoid signaling.
4.Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition)
Jianling FAN ; Tiejun WANG ; Pengfei YANG ; Keke DING ; Xiaoning HAO ; Sunfang JIANG ; Ankang LÜ ; Jianping LU ; Sheng RONG ; Weibin SHI ; Shengwei SUN ; Yan TAN ; Qilei TU ; Zhiping WANG ; Bing WANG ; Jianyun WANG ; Weijian WANG ; Yan WANG ; Qun XU ; Chenli ZHANG ; Fan ZHANG ; Ping ZHANG ; Yansong ZHENG ; Jieru ZHOU ; Dan CHEN ; Jiaoyang ZHENG
Chinese Journal of Clinical Medicine 2025;32(6):1097-1111
Obesity, as a chronic recurrent disease, has become a major public health challenge in China. To implement the requirements of the Healthy China Initiative (2019—2030), under domestic guidelines or consensus statements on overweight and obesity, and in alignment with the latest scientific advances globally, the Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition) was developed. This protocol was drafted by the Health Management Center of Shanghai Changzheng Hospital and formulated through multiple rounds of deliberation by experts in China’s health examination quality control field. The protocol establishes unified standards for screening facilities, personnel qualifications, and measurement or testing procedures. It defines specific screening items, outlines a standardized screening pathway, and sets requirements for the final medical review, ensuring the scientific validity, effectiveness, and safety of the screening process. The implementation of this protocol will enhance the consistency of weight management practices for adults across health examination institutions and strengthen the quality control of overweight and obesity screening programs.
5.The expression of IQGAP2 in renal cell carcinoma and its effect on the malignant biological behavior of renal cell carcinoma
Hao CHEN ; Yunfeng NIU ; Qi WANG ; Ting LÜ ; Tao LI ; Kunpeng ZENG ; Bo FAN
The Journal of Practical Medicine 2025;41(9):1273-1284
Objective To investigate the expression pattern of IQGAP2 in renal cell carcinoma tissues and cell lines,and to analyze its effects on the proliferation and migration of renal cell carcinoma cells.Methods Firstly,GEO database was used to screen differentially expressed genes between renal cell carcinoma tissues,and GEPIA,TIMER2.0 were used to analyze the expression level of IQGAP2 in renal cell carcinoma tissue.Subse-quently,knockdown(siRNA)and overexpression plasmids of IQGAP2 were constructed and transfected into ACHN and 786-O cell lines to perform a series of functional experiments to evaluate the effect of IQGAP2 on the malignant biological behavior of renal carcinoma cells.qRT-PCR and Western Blot were used to detect the expres-sion of EMT(epithelial-mesenchymal transition)related proteins after knockdown and overexpression of IQGAP2.Results In renal cell carcinoma tissues,the relative expression of IQGAP2 was significantly lower than in adja-cent normal tissues(P<0.001).Transfection of si-IQGAP2 in ACHN and 786-O cells effectively downregulated the mRNA and protein expression levels of IQGAP2(P<0.01),while transfection with an overexpression plasmid significantly upregulated its mRNA and protein expression(P<0.001).Further studies revealed that overexpression of IQGAP2 significantly inhibited the proliferation(P<0.05)and migration(P<0.01)of ACHN and 786-O cells,whereas knockdown of IQGAP2 enhanced their proliferation(P<0.05,P<0.001)and migration(P<0.01).Through qRT-PCR and Western blot analyses of EMT-related proteins,it was found that reduced expression of IQGAP2 promoted the epithelial-mesenchymal transition(EMT)process in renal cancer cells.Conclusions The expression of IQGAP2 is low in renal cell carcinoma tissues and cells,and the decrease of the expression level can promote the EMT process of renal cell carcinoma cells,and then enhance the proliferation and migration of renal cell carcinoma cells.IQGAP2 plays an important tumor suppressor role in renal cell carcinoma.
6.Effect and mechanism of polystyrene microplastics on prostate in male mice
Chun PAN ; Zhencheng FAN ; Runyang HONG ; Yujie SHI ; Hao CHEN
Chinese Journal of Tissue Engineering Research 2025;29(34):7353-7361
BACKGROUND:Microplastics are a common environmental pollutant that can cause damage to the gastrointestinal tract,liver and kidney,and reproductive system.However,little is known about the effects of microplastics on the prostate.OBJECTIVE:To investigate the effects of different charge-modified polystyrene microplastics on prostate tissues of male mice and its mechanism.METHODS:A total of 48 male BALB/c mice were randomly divided into a control group,an unmodified microplastic group,a negatively charged microplastic group,and a positively charged microplastic group using a random number table,with 12 mice in each group.The mice in the control group were given ddH2O by gavage;the mice in the unmodified microplastic group were given unmodified polystyrene microplastics by gavage,and the mice in the negatively charged microplastic group and the positively charged microplastic group were given negatively charged polystyrene microplastics and positively charged polystyrene microplastics by gavage,respectively,once a day for 4 consecutive weeks.The body weight,drinking water,and food intake of the mice were detected every week.After gavage,the prostate mass,prostate coefficient,prostate histopathological morphology,inflammatory factor expression,microplastic accumulation in the prostate tissue of the mice,and the mRNA and protein expressions of hypoxia-inducible factor 1α and vascular endothelial growth factor were compared among the groups of mice.RESULTS AND CONCLUSION:(1)With the prolongation of microplastic exposure time,the body weight of mice in the unmodified microplastics group and the positively charged microplastics exposure group was significantly suppressed.(2)After exposure to microplastics,they could enter the urinary system of mice,including prostate and bladder tissue.Among the mice in the positively charged microplastic group,the prostate mass and prostate coefficient increased most significantly.(3)Compared with the control group,the mass concentration and mRNA expression of interleukin 6,interleukin 1β,and tumor necrosis factorα were increased in the prostate tissue of the other three groups of mice(P<0.05).Among them,the positively charged microplastic group exhibited most obvious increase.(4)Hematoxylin-eosin staining showed that the prostate tissue of mice in the unmodified microplastic group,negatively charged microplastic group,and positively charged microplastic group showed obvious proliferation of prostate epithelial cells and matrix,a significant increase in acini,and infiltration of a large number of inflammatory cells.Masson and Sirius red staining showed that compared with the control group,the prostate tissue of mice in the other three groups had obvious fibrosis.Immunohistochemical staining showed that compared with the control group,angiogenesis in the prostate tissue of mice increased in the other three groups(P<0.05).(5)Compared with the control group,the mRNA and protein expressions of hypoxia-inducible factor 1αand vascular endothelial growth factor were increased in the prostate tissue of the other three groups of mice(P<0.05),among which the negatively charged microplastic group and the positively charged microplastic group exhibited more significant increase.(6)The results show that polystyrene microplastics can enhance the release of inflammatory factors in mouse prostate tissue,promote angiogenesis in prostate tissue by activating the hypoxia-inducible factor 1α/vascular endothelial growth factor signaling pathway,and provide nutrition support for prostate hyperplasia and fibrosis.
7.Consensus on informed consent for orthodontic treatment
Yang CAO ; Bing FANG ; Zuolin JIN ; Hong HE ; Yuxing BAI ; Lin WANG ; Haiping LU ; Zhihe ZHAO ; Tianmin XU ; Weiran LI ; Min HU ; Jinlin SONG ; Jun WANG ; Fang JIN ; Ding BAI ; Xianglong HAN ; Yuehua LIU ; Bin YAN ; Jie GUO ; Jiejun SHI ; Yongming LI ; Zhihua LI ; Xiuping WU ; Jiangtian HU ; Linyu XU ; Lin LIU ; Yi LIU ; Yanqin LU ; Wensheng MA ; Shuixue MO ; Liling REN ; Shuxia CUI ; Yongjie FAN ; Jianguang XU ; Lulu XU ; Zhijun ZHENG ; Peijun WANG ; Rui ZOU ; Chufeng LIU ; Lunguo XIA ; Li HU ; Weicai WANG ; Liping WU ; Xiaoxing KOU ; Jiali TAN ; Yuanbo LIU ; Bowen MENG ; Yuantao HAO ; Lili CHEN
Chinese Journal of Stomatology 2025;60(12):1327-1336
This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.
8.Isolation,identification,and biological characterization of enterotoxigenic Escherichia coli from a South China tiger
Jing-ru XU ; Zhi-hao ZHU ; Yu-qi LI ; Si-si FAN ; Ya-li KANG ; Yu-bin ZHUO ; Ling-shan HUANG ; Shu-qi QIU ; XUE-YUXI ; Xiao-ping WU ; Yu-ting LIAO ; Wei-ye LIN ; Xiao-ziyi XIAO ; Xue-jin LI ; Teng-teng CHEN ; Xi-pan LIN ; Kai-xiong LIN ; Ke-wei FAN
Chinese Journal of Zoonoses 2025;41(6):567-573
This study was aimed at identifying the pathogenic bacteria responsible for the death of a young tiger at the Fujian Meihua Mountain South China Tiger Breeding Research Institute.Tissue samples from the lungs,liver,and intestines of the deceased tiger were collected,and the bacteria were cultured inasterile environment.The bacterial strains were characterized according to their morphological and molecular biological properties,including assessment of virulence genes and antibiotic resistance genes,mouse lethality tests,and antibiotic susceptibility evaluations.A predominant bacterial strain isolated from the liver of the deceased tiger was identified as enterotoxigenic Escherichia coli(ETEC)strain Tiger22513F.Phylogenetic analysis of the 16S rRNA gene revealed that the Tiger22513F strain exhibited close genetic similarity to the reference strain ETEC(MF919609.1),with 99.9%nucleotide similarity,and resided on the same evolutionary branch.The Tiger22513F strain contained 11 antibiotic resistance genes(tetA,sul1,sul3,cmlA,floR,blaTEM,blaSHV,blaCMY-2,qnrA,qnrS,and qnrD)along with five virulence genes(VT1,fyuA,tsh,iucD,and ST).Mouse lethality tests indicated significant pathogenicity toward mice,affecting primarily the lungs,liver,and intestines.Antibiotic susceptibility testing demonstrated that this strain exhibited resistance to various classes of beta-lactam antibiotics,as well as quinolones and aminoglycosides.This investigation successfully isolated a multi-drug resistant enterotoxigenic Escherichia coli strain with pronounced pathogenicity from the liver of a deceased tiger;thus providing valuable scientific insights for clinical diagnosis,as well as prevention and control measures,against ETEC infections in South China tigers.
9.Effect and mechanism of polystyrene microplastics on prostate in male mice
Chun PAN ; Zhencheng FAN ; Runyang HONG ; Yujie SHI ; Hao CHEN
Chinese Journal of Tissue Engineering Research 2025;29(34):7353-7361
BACKGROUND:Microplastics are a common environmental pollutant that can cause damage to the gastrointestinal tract,liver and kidney,and reproductive system.However,little is known about the effects of microplastics on the prostate.OBJECTIVE:To investigate the effects of different charge-modified polystyrene microplastics on prostate tissues of male mice and its mechanism.METHODS:A total of 48 male BALB/c mice were randomly divided into a control group,an unmodified microplastic group,a negatively charged microplastic group,and a positively charged microplastic group using a random number table,with 12 mice in each group.The mice in the control group were given ddH2O by gavage;the mice in the unmodified microplastic group were given unmodified polystyrene microplastics by gavage,and the mice in the negatively charged microplastic group and the positively charged microplastic group were given negatively charged polystyrene microplastics and positively charged polystyrene microplastics by gavage,respectively,once a day for 4 consecutive weeks.The body weight,drinking water,and food intake of the mice were detected every week.After gavage,the prostate mass,prostate coefficient,prostate histopathological morphology,inflammatory factor expression,microplastic accumulation in the prostate tissue of the mice,and the mRNA and protein expressions of hypoxia-inducible factor 1α and vascular endothelial growth factor were compared among the groups of mice.RESULTS AND CONCLUSION:(1)With the prolongation of microplastic exposure time,the body weight of mice in the unmodified microplastics group and the positively charged microplastics exposure group was significantly suppressed.(2)After exposure to microplastics,they could enter the urinary system of mice,including prostate and bladder tissue.Among the mice in the positively charged microplastic group,the prostate mass and prostate coefficient increased most significantly.(3)Compared with the control group,the mass concentration and mRNA expression of interleukin 6,interleukin 1β,and tumor necrosis factorα were increased in the prostate tissue of the other three groups of mice(P<0.05).Among them,the positively charged microplastic group exhibited most obvious increase.(4)Hematoxylin-eosin staining showed that the prostate tissue of mice in the unmodified microplastic group,negatively charged microplastic group,and positively charged microplastic group showed obvious proliferation of prostate epithelial cells and matrix,a significant increase in acini,and infiltration of a large number of inflammatory cells.Masson and Sirius red staining showed that compared with the control group,the prostate tissue of mice in the other three groups had obvious fibrosis.Immunohistochemical staining showed that compared with the control group,angiogenesis in the prostate tissue of mice increased in the other three groups(P<0.05).(5)Compared with the control group,the mRNA and protein expressions of hypoxia-inducible factor 1αand vascular endothelial growth factor were increased in the prostate tissue of the other three groups of mice(P<0.05),among which the negatively charged microplastic group and the positively charged microplastic group exhibited more significant increase.(6)The results show that polystyrene microplastics can enhance the release of inflammatory factors in mouse prostate tissue,promote angiogenesis in prostate tissue by activating the hypoxia-inducible factor 1α/vascular endothelial growth factor signaling pathway,and provide nutrition support for prostate hyperplasia and fibrosis.
10.Isolation,identification,and biological characterization of enterotoxigenic Escherichia coli from a South China tiger
Jing-ru XU ; Zhi-hao ZHU ; Yu-qi LI ; Si-si FAN ; Ya-li KANG ; Yu-bin ZHUO ; Ling-shan HUANG ; Shu-qi QIU ; XUE-YUXI ; Xiao-ping WU ; Yu-ting LIAO ; Wei-ye LIN ; Xiao-ziyi XIAO ; Xue-jin LI ; Teng-teng CHEN ; Xi-pan LIN ; Kai-xiong LIN ; Ke-wei FAN
Chinese Journal of Zoonoses 2025;41(6):567-573
This study was aimed at identifying the pathogenic bacteria responsible for the death of a young tiger at the Fujian Meihua Mountain South China Tiger Breeding Research Institute.Tissue samples from the lungs,liver,and intestines of the deceased tiger were collected,and the bacteria were cultured inasterile environment.The bacterial strains were characterized according to their morphological and molecular biological properties,including assessment of virulence genes and antibiotic resistance genes,mouse lethality tests,and antibiotic susceptibility evaluations.A predominant bacterial strain isolated from the liver of the deceased tiger was identified as enterotoxigenic Escherichia coli(ETEC)strain Tiger22513F.Phylogenetic analysis of the 16S rRNA gene revealed that the Tiger22513F strain exhibited close genetic similarity to the reference strain ETEC(MF919609.1),with 99.9%nucleotide similarity,and resided on the same evolutionary branch.The Tiger22513F strain contained 11 antibiotic resistance genes(tetA,sul1,sul3,cmlA,floR,blaTEM,blaSHV,blaCMY-2,qnrA,qnrS,and qnrD)along with five virulence genes(VT1,fyuA,tsh,iucD,and ST).Mouse lethality tests indicated significant pathogenicity toward mice,affecting primarily the lungs,liver,and intestines.Antibiotic susceptibility testing demonstrated that this strain exhibited resistance to various classes of beta-lactam antibiotics,as well as quinolones and aminoglycosides.This investigation successfully isolated a multi-drug resistant enterotoxigenic Escherichia coli strain with pronounced pathogenicity from the liver of a deceased tiger;thus providing valuable scientific insights for clinical diagnosis,as well as prevention and control measures,against ETEC infections in South China tigers.

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