With the accelerating trend of population aging, the number of elderly patients with lung cancer continues to rise, and the disease burden is becoming increasingly heavy. The clinical management of these patients faces severe challenges due to their decreased physiological reserve, complex comorbidities, and significant individual heterogeneity. Consequently, under traditional diagnosis and treatment models, doctors often struggle to identify the individualized risks of elderly patients in a timely and comprehensive manner, which can easily lead to decision biases such as undertreatment or overtreatment. In view of this, this study advocates for the establishment of an umbrella decision-making model specifically tailored for elderly lung cancer patients. Grounded in a multidisciplinary team (MDT) platform, this model deeply integrates oncological indicators with the comprehensive geriatric assessment (CGA) system. By holistically considering multidimensional variables including tumor burden, organ function, frailty index, cognitive status, and social support, the model establishes an operational mechanism characterized by "single entry, precise stratification, and targeted selection". Accordingly, patients can be scientifically triaged into distinct intervention tiers, such as active surveillance, minimally invasive surgery, drug therapy, radiotherapy, and best supportive care, thereby achieving real-time alignment between treatment intensity and patient fitness. This article elaborates on the construction logic and key operational procedures of this novel decision-making framework, aiming to guide clinical practice beyond the limitations of a tumor-centric perspective toward a holistic, dynamic, whole-course management strategy. This transition seeks to ensure optimal quality of life and clinical net benefit for elderly patients alongside survival prolongation.

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:To investigate immunotherapy effects and mechanism of BCG and recombinant BCG(rBCG)with c-di-AMP as adjuvant on melanoma in mice model.Methods:Melanoma mice model was established by B16F10 cell subcutaneous injec-tion in groin,and treated with 1×106 CFU of BCG and rBCG by adjacent injection of subcutaneous tumor for 3 times,respectively.Survival of melanotic mice,tumor growth and metastasis were observed.Tumor tissues of mice were isolated to prepare cell suspen-sion,and proportion of immune cells were detected by flow cytometry.Transcriptional levels of immune-related genes in tumor tissues were detected by qRT-PCR.Results:Both BCG and rBCG immunotherapy could significantly inhibit growth in melanoma mice and prolong survival time of mice.rBCG showed better inhibition on metastasis than BCG.Both strains significantly reduced proportion of M2-type macrophages and myeloid-derived suppressor cell associated with tumor growth and metastasis.Both two strains promoted infiltration of lymphocytes in tumor tissues,and rBCG significantly increased proportion of B cells in tumor.BCG immunotherapy upregulated transcription levels of metastasis-related cytokines,while rBCG therapy had no effects on transcriptions of these genes.Conclusion:Both BCG and rBCG have immunotherapeutic effects on melanotic mice,and rBCG with c-di-AMP as adjuvant shows better inhibition on tumor metastasis than BCG,which mechanism was related to regulation of immune response in tumor tissues.

BACKGROUND:During the treatment of posterolateral tibial plateau fractures through the fibular head approach,the gap between the fibular head and the lateral plateau cannot accommodate the posterior placement of a plate for all patients.OBJECTIVE:To analyze,via finite element analysis,the differences in fixation strength resulting from varying the angles and quantities of horizontal arm variable angle screws in the plate during the treatment of posterolateral tibial plateau fractures through the fibular head approach.METHODS:A finite element model was established based on CT images of the knee to ankle joints of a 30-year-old healthy adult male volunteer.The models were divided into two categories:posteriorly placed group and non-posteriorly placed group based on whether the lateral locking compression plate was posteriorly placed.The posteriorly placed group was further subdivided into groups A-D based on the offset angle of the two variable angle screws(0°,5°,10°,and 15°).The non-posteriorly placed group was subdivided into groups E and F based on offset angles(0° and 15°).Finite element analysis was used to evaluate the von Mises stress distribution,maximum von Mises stress,and compressive displacement under loads of 250,500,and 750 N,exploring the mechanical differences between the groups.RESULTS AND CONCLUSION:(1)Finite element analysis results showed that under a 750 N load,the maximum compressive displacement trend of the internal fixation device was D＜B=C=F＜A＜E.The trend for maximum von Mises stress was B＜C＜A＜D＜F＜E.The trend for maximum compressive displacement on the bone was C=D＜B＜A＜F＜E,and for maximum von Mises stress,it was B＜C＜A＜F＜D＜E.The displacement and stress trends for the six models were similar under loads ranging from 250 N to 750 N.(2)These results suggest that for posterolateral tibial plateau fractures fixed through the fibular head approach,posterior placement of the plate should aim to accommodate two screws.If only one screw can be fixed during surgery,variable angle screws should be offset in the range of 0-15° to increase the probability of securing two screws.

Objective To investigate the predictive value of serum interleukin-17(IL-17)and soluble hemoglobin scavenger receptor 163(sCD163)for early anastomotic leakage in patients with colorectal cancer after laparoscopic surgery.Methods From June 2022 to June 2024,80 colorectal cancer patients who underwent laparoscopic surgery were selected as the study subjects.Patients were subdivided into an anastomotic leakage group(17 cases)and a non-anastomotic leakage group(63 cases)according to whether an anastomotic leakage occurred within 7 d postoperatively.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the levels of serum IL-17 and sCD163 in patients on preoperative day 1,postoperative day 1,postoperative day 3,postoperative day 5,and postoperative day 7.The clinical data of the two groups were compared.Multivariate Logistic regression was applied to analyze the influencing factors of early anastomotic leakage in colorectal cancer patients after laparoscopic surgery.The receiver operating characteristic curve(ROC curve)was applied to analyze the predictive value of serum IL-17 and sCD163 levels for early anastomotic leakage in colorectal cancer patients after laparoscopic surgery.Results The percentage of distance between tumor and anus＜7 cm was higher in the anastomotic leakage group than that in the non-anastomotic leakage group,and the amount of drainage was more than that in the non-anastomotic leakage group at 7 d postoperatively,the differences were statistically significant(P＜0.05).There were statistically significant differences in the levels of serum IL-17 and sCD163 between the two groups of patients at different time points,as well as in time and interaction effects(P＜0.05).Distance between tumor and anus＜7 cm(O R=3.176,95％CI:1.128～8.940),serum IL-17 level ≥ 43.95 pg/mL at 3 d postoperatively(O R=2.145,95％CI:1.281～3.592),and serum sCD163 level ≥ 81.02 pg/mL at 5d postoperatively(OR=1.852,95％CI:1.225～2.801)were the risk factors of early anastomotic leakage in patients with colorectal cancer after laparoscopic surgery(P＜0.05).The area under the curve(AUC)of the combination of serum IL-17 and sCD163 in predicting early anastomotic leakage in colorectal cancer patients after laparoscopic surgery was 0.923,which was superior to the single diagnosis of serum IL-17 and sCD163(Zcombination-IL-17=2.77,Zcombination-sCD163=2.11,P＜0.05).Conclusion Serum IL-17 and sCD163 levels are elevated in colorectal cancer patients with early anastomotic leakage after laparoscopic surgery.The combined detection of the two has certain clinical value in predicting early anastomotic leakage in patients with colorectal cancer after laparoscopic surgery.

Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Excessive ionizing radiation can disrupt the molecular structures of organisms,leading to health issues such as acute radiation syndrome and cancer,posing serious threats to human health.The development of radioprotective drugs holds significant importance for mitigating ionizing radiation damage and safeguarding public health,yet its research process faces multidimensional ethical challenges.This paper systematically explores the ethical issues involved in the full lifecycle of radioprotective drug development,focusing on the ethical particularities of animal experimentation,ethical dilemmas in human trials,data privacy and security risks,as well as challenges in managing conflicts of interest.Targeted solutions are proposed,including strengthening ethical review mechanisms,promoting interdisciplinary collaboration,constructing data security management systems,and establishing conflict-of-interest mediation mechanisms.These comprehensive measures aim to build a scientifically rigorous ethical framework for radioprotective drug research,fostering sustainable development in this field.

Objective To investigate the predictive value of serum interleukin-17(IL-17)and soluble hemoglobin scavenger receptor 163(sCD163)for early anastomotic leakage in patients with colorectal cancer after laparoscopic surgery.Methods From June 2022 to June 2024,80 colorectal cancer patients who underwent laparoscopic surgery were selected as the study subjects.Patients were subdivided into an anastomotic leakage group(17 cases)and a non-anastomotic leakage group(63 cases)according to whether an anastomotic leakage occurred within 7 d postoperatively.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the levels of serum IL-17 and sCD163 in patients on preoperative day 1,postoperative day 1,postoperative day 3,postoperative day 5,and postoperative day 7.The clinical data of the two groups were compared.Multivariate Logistic regression was applied to analyze the influencing factors of early anastomotic leakage in colorectal cancer patients after laparoscopic surgery.The receiver operating characteristic curve(ROC curve)was applied to analyze the predictive value of serum IL-17 and sCD163 levels for early anastomotic leakage in colorectal cancer patients after laparoscopic surgery.Results The percentage of distance between tumor and anus＜7 cm was higher in the anastomotic leakage group than that in the non-anastomotic leakage group,and the amount of drainage was more than that in the non-anastomotic leakage group at 7 d postoperatively,the differences were statistically significant(P＜0.05).There were statistically significant differences in the levels of serum IL-17 and sCD163 between the two groups of patients at different time points,as well as in time and interaction effects(P＜0.05).Distance between tumor and anus＜7 cm(O R=3.176,95％CI:1.128～8.940),serum IL-17 level ≥ 43.95 pg/mL at 3 d postoperatively(O R=2.145,95％CI:1.281～3.592),and serum sCD163 level ≥ 81.02 pg/mL at 5d postoperatively(OR=1.852,95％CI:1.225～2.801)were the risk factors of early anastomotic leakage in patients with colorectal cancer after laparoscopic surgery(P＜0.05).The area under the curve(AUC)of the combination of serum IL-17 and sCD163 in predicting early anastomotic leakage in colorectal cancer patients after laparoscopic surgery was 0.923,which was superior to the single diagnosis of serum IL-17 and sCD163(Zcombination-IL-17=2.77,Zcombination-sCD163=2.11,P＜0.05).Conclusion Serum IL-17 and sCD163 levels are elevated in colorectal cancer patients with early anastomotic leakage after laparoscopic surgery.The combined detection of the two has certain clinical value in predicting early anastomotic leakage in patients with colorectal cancer after laparoscopic surgery.

Excessive ionizing radiation can disrupt the molecular structures of organisms,leading to health issues such as acute radiation syndrome and cancer,posing serious threats to human health.The development of radioprotective drugs holds significant importance for mitigating ionizing radiation damage and safeguarding public health,yet its research process faces multidimensional ethical challenges.This paper systematically explores the ethical issues involved in the full lifecycle of radioprotective drug development,focusing on the ethical particularities of animal experimentation,ethical dilemmas in human trials,data privacy and security risks,as well as challenges in managing conflicts of interest.Targeted solutions are proposed,including strengthening ethical review mechanisms,promoting interdisciplinary collaboration,constructing data security management systems,and establishing conflict-of-interest mediation mechanisms.These comprehensive measures aim to build a scientifically rigorous ethical framework for radioprotective drug research,fostering sustainable development in this field.

Objective To investigate the risk factors for pneumonia complicating infectious mononucleosis(IM)in adults and construct a nomogram prediction model.Methods A retrospective analysis was conducted on 198 IM patients admitted to the Second Affiliated Hospital of Air Force Medical University from January 2015 to December 2021.Patients were divided into pneumonia group(n=52)and non-pneumonia group(n=146)based on whether pulmonary infection occurred during hospitalization.The baseline data(age,gender,place of onset,etc.),clinical manifestations(maximum body temperature,lymph node enlargement,splenomegaly,etc.),and inflammatory indicators[white blood cell count(WBC),C-reactive protein(CRP),etc.]were compared between the two groups.Kaplan-Meier curves were plotted to analyze the key indicators affecting the hospital stay of IM patients.Multivariate logistic regression was used to analyze the independent risk factors for pneumonia complicating IM in adults and construct a nomogram prediction model based on the identified risk factors.The predictive efficacy of the model was evaluated using the receiver operating characteristic(ROC)curve and the consistency of the model was assessed using the calibration curve.The fit of the model was evaluated using the Hosmer-Lemeshow test.Additionally,the sensitivity,specificity,and accuracy of the model were assessed using confusion matrix.Results Compared with non-pneumonia group,the pneumonia group had a significantly higher proportion of patients from rural areas,with body mass index(BMI)≥24 kg/m2,smoking history,hepatomegaly,fever duration of≥7 d,as well as increased total hospitalization costs and average daily hospitalization costs,and prolonged hospital stay(P<0.05).The proportion of patients with a history of antibiotic use was lower in the pneumonia group(P<0.05).Kaplan-Meier survival analysis showed that patients from rural areas,with BMI≥24 kg/m2,smoking history,no prophylactic use of antibiotics,fever duration≥7 d,and hepatomegaly had significantly prolonged hospital stays(P<0.05).Multivariate logistic regression analysis revealed that living in a rural area(OR=4.089,P<0.05),hepatomegaly(OR=4.082,P<0.05),and elevated WBC(OR=1.205,P<0.05)were independent risk factors for pneumonia complicating IM in adults,while the prophylactic use of antibiotics(OR=0.142,P<0.05)was an independent protective factor.The area under the ROC curve of the constructed nomogram prediction model was 0.827(95%CI 0.762-0.892),and the slope of the calibration curve was close to 1,and the Hosmer-Lemeshow test showed χ2=5.299,P=0.725,indicating good consistency and fit of the prediction model.The results of the confusion matrix assessment showed that the sensitivity of the model was 0.669(0.624-0.773),the specificity was 0.827(0.724-0.930),and the accuracy was 0.732(0.665-0.793).Conclusion The nomogram prediction model based on place of onset,hepatomegaly,the prophylactic use of antibiotics and WBC has excellent fit and discrimination,providing an effective quantitative tool for prognosis assessment of IM.